Connection between tobacco use, mental health important to understand

According to the American Academy of Family Physicians, adults with a behavioral health disorder (i.e., a mental health disorder and/or a substance use disorder) are more likely than others to be tobacco users and face additional problems because of that.

Purdue, along with the state of Indiana and nationwide agencies, provides support for tobacco cessation and behavioral health disorders. The need for such resources is confirmed by numerous agencies and organizations.

The American Lung Association, via its Behavioral Health & Tobacco Use webpage, shares a variety of statistics on tobacco and mental health, such as:

• It is estimated that 35% of cigarette smokers have a behavioral health disorder and account for 38% of all U.S. adult cigarette consumption.
• Despite the national cigarette smoking rate being 14% overall among adults, it is 23% for individuals with a behavioral health disorder.
• The nicotine dependency rate for individuals with behavioral health disorders is two to three times higher than the general population.
• Lifetime smoking rates are higher in patients who are diagnosed with major depression disorder (59%), bipolar disorder (83% ), or schizophrenia and other psychotic disorders (90%) compared with 32% among adults with no mental illness.
• Among current smokers with a lifetime history of depression, anxiety, anxiety with depression or major depression, they smoke more cigarettes, smoke more frequently and have a higher level of dependence.
• The presence or history of depression is associated with greater smoking severity and poorer smoking outcomes.

“The connection between nicotine use and mental health is a vicious cycle,” said Lindsay Bloom, health coach at Purdue Fort Wayne. “Statistics show the connection between those living with mental health issues and the use of tobacco (smoking, vaping, etc.). This increase can be linked to individuals wanting to self-medicate to help alleviate symptoms of their mental health issues; however, using tobacco doesn’t really alleviate the symptoms. In reality, it negatively impacts mental health. Over time, smoking can lead to lower levels of dopamine production by the brain, which then triggers a need to smoke more to increase the dopamine levels.”

Thus at the same time that individuals with mental health issues smoke and use tobacco at higher rates, effects of the usage can also bring about mental health concerns such as:

• Addiction.
• Stress.
• Depression.
• Schizophrenia.

A study, published in 2019 in Psychological Medicine, found that smokers had nearly double the risk of developing depression or schizophrenia that nonsmokers had. Its conclusions statement reads: “These findings suggest that the association between smoking, schizophrenia and depression is due, at least in part, to a causal effect of smoking, providing further evidence for the detrimental consequences of smoking on mental health.”

Quitting tobacco

According to the Centers for Disease Control and Prevention, not only does quitting tobacco provide extensive physical health benefits but it also supports behavioral health treatment and could improve mental health. Additionally, Truth Initiative, America’s largest nonprofit public health organization committed to making tobacco use and nicotine addiction a thing of the past, reports that quitting smoking is linked with lower levels of anxiety, depression and stress. Truth Initiative’s Quitting nicotine can alleviate mental health symptoms webpage provides additional details.

Purdue provides tobacco cessation resources for benefits-eligible employees on all campuses and dependents covered on a Purdue health plan, including one-to-one counseling via the Center for Healthy Living (CHL) and Healthy Boiler tobacco cessation lifestyle programs. In addition, the Indiana Tobacco Quitline is provided by the state Department of Health to all residents of Indiana and is available seven days a week.

Upcoming ‘Tobacco Cessation’ Healthy Boiler lifestyle program

For those who are ready to quit smoking or who are thinking about quitting, the upcoming Healthy Boiler lifestyle program “Tobacco Cessation” is a great resource. The program, which will meet virtually from noon to 1 p.m. ET on Tuesdays from May 31 to June 28, teaches strategies to help individuals quit and stay quit. Bloom is the instructor.

Those interested in participating should register by April 28 via the Healthy Boiler Portal. The registration link can be found under the “Healthy Boiler Workshops” section on the portal’s homepage. Hover over the workshop’s square and hit “Submit” to register.

Participating in this program will count as an approved tobacco cessation program, resulting in a partial waiver of the 2022 tobacco-user additional premium, once completed program certificate is submitted.

Tobacco-user additional premium information     

Aside from the health (physical and behavioral) benefits resulting from not smoking, there are also financial benefits, including a waiver of the tobacco-user additional premium on an employee’s benefits premium. As a reminder, employees, and their spouse if covered, who certify as tobacco users (a person who has used tobacco, including cigars, cigarettes, electronic cigarettes, chewing tobacco, pipe tobacco or any other tobacco product in the past 12 months) during open enrollment each year will pay an additional $1,000 tobacco-user premium on their medical benefits. Premiums for term life, universal life and critical illness insurance also are based in part on whether an employee (and their spouse, if covered) have used tobacco in the last 12 months and those premiums may be affected as well.

Completed program certificates from an approved tobacco cessation program submitted after March 31 will waive the tobacco-user additional premium for the remainder of the 2022 plan year.

For more information about the additional premium, visit the Purdue Medical Plan Tobacco-User Additional Premium: Questions and Answers webpage.

More information on tobacco use and mental health

• Drug Interaction with Tobacco Smoke Guide – American Academy of Family Physicians
• Tobacco Use and Mental Health Fact Sheet – World Health Organization Regional Office for Europe
• What to Know About Tobacco and Your Mental Health – WebMD
• What We Know – Tobacco Use And Quitting Among Individuals With Behavioral Health Conditions – Centers for Disease Control and Prevention

ADDITIONAL MENTAL HEALTH RESOURCES

To assist faculty and staff

Review the Mental Health Resources webpage for a variety of available resources for faculty and staff, including EAP resources for all Purdue campuses, information on Purdue’s health plan coverage for mental health and substance abuse as well as behavioral health referral locations for the West Lafayette, Fort Wayne and Northwest campuses. 

To assist students

Faculty and staff, who work with students or have a student at home, can direct students to the resources below for behavioral health assistance. Note: LiveHealth Online Psychology and LiveHealth Online Psychiatry services are also available to Purdue students who are covered on a Purdue health plan. Mental health visits through LiveHealth Online are covered fully on the Purdue student health plan.  

Office of the Dean of Students

• Continuous network of support
• Services and information
• Presentations and trainings
• Student of Concern reporting link

Counseling and Psychological Services (CAPS)

• Therapy services at CAPS
• Self-help resources
• Group therapy
• CAPS YouTube channel
• NAMI On Campus – A free, virtual support group on campus.
• Thriving Campus – Service that provides students a way to search for mental health providers in many areas, locally and across the country.
• WellTrack – Interactive, self-help therapy app for students.